Penile Hypospadias
Conditions
Brief summary
Hypospadias is a common congenital anomalies in male children affecting 1 in 200-300 male births, the penis urethral opening is found ventrally, penile curvature and a lack of foreskin (1). Multiple operations are described , Tubularised incised-plate is the preferred option for distal hypospadias and with trial to extend the operation indication to proximal and redo hypospadias (2). Its simple operative technique made TIP repair gain worldwide acceptance in addition to the low complication rate & good cosmetic outcome (3).It has several complication as stenosis meatus, fistula formation , uretheral stricture and failed repair (4). Objective scoring systems were introduced to allow better judgment and identification of the postoperative results, depending on pre-operative and intra-operative criteria (5). Modifications of the T.I.P operation was done to reduce complication and allow better results by using a graft , Snodgraft vs Snodgrass operation are nearly equal regarding the outcomes (6). To our knowledge there is no definite recommendation.
Interventions
PROCEDURERepair surgery
1. a circumscribing skin incision was made 2 mm below the hypospadias meatus, 2. penile degloving, 3. the para-urethral plate incision was made, 4. A vertical midline incision of the urethral plate was made from within the hypospadiac meatus and extended up to the mid-glans. 5. The urethral plate was tubularised, beginning proximally, and closed in two layers using 6/0 polyglactin 910 suture. 6. The neomeatus was formed on a catheter 2 F larger than the urethral stent. 7. A flap was harvested from the prepuce to cover the neourethra and finally glanuloplasty. 8. A suitable urethral stent was left in situ for 7-10 days, with a compressive dressing applied. * Grafted tubularised incised-plate . 1.Same steps but adding a graft (dorsal inlay) , 2. The graft will be taken from the inner preputial skin . 3. The graft will be sutured to overlying plate incision line from the old meatus to the tip of the glans.
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
1 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
1. Children age more than 12 months to 12 years. 2. De-novo penile hypospadias after degloving of penis intraoperative (fresh, not previously operated)
Exclusion criteria
1. Circumcised 2. Ventral Penile curvature ≥30° after penile degloving & artificial erection, (requiring transection of urethral plate). 3. Uretheral plate less than 6mm 4. Megameatus intact prepuce 5. Albumin less than 3.5 g/dL
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Operation time. | intraoperative | the duration of the operation will be measured from the start of anesthesia to end. |
| blood loss. | one hour postoperatively | the amount of blood loss will be measured by CBC |
| site of the meatus | 6 months from the operation | the meatal position will be measured in centimeters from the original position . |
Countries
Egypt
Contacts
Primary Contactabdelrahman M abdelkader
Outcome results
None listed